Chronic Nonspecific Tenosynovitis of Flexor Tendon Sheath (With Rice Bodies) in the Hand- Ten Years Follow Up.

Abstract

Rice bodies are fibrous bodies resembling grains of rice. They are associated with many inflammatory conditions like rheumatoid arthritis, tuberculosis, juvenile arthritides, seronegative arthritis, osteoarthritis, septic joints and chronic bursitis. Rice bodies are seen in pleural fluid, in the setting of bursitis and within the tendon sheath. We describe a rare case of Rice body tenosynovitis of flexor tendon sheath of a finger in a hand that showed no evidence of any infection or rheumatic disease after repetitive diagnostic procedures. Case presentation: We report a case of forty-nine-year-old fisherman presenting with progressive, painless sausage shaped swelling of right hand middle finger for two years. Discussion: Rice bodies are formed in inflammatory joint diseases and mostly with tuberculous etiology but rarely found in non-tuberculous patient. This a case of Rice body formation associated with chronic Nonspecific tenosynovitis of middle finger right hand. Conclusion: Rice bodies in the distal palm to digital flexor tendon sheath of Right-hand middle finger with no specific etiology are extremely rare clinical Presentation. MRI, radiography and histopathology were useful in arriving at a Diagnosis. Over the period of 10 years, only one flexor tendon sheath of right hand middle finger was affected, without any other disability. Since his occupationis fishing, may be bite of the fish may be a reason. This chronic inflammation of the middle finger tendon sheath of the flexor tendon was confined only to that finger over the past 10 years. Now after complete excision of the sheath, he is free of this problem and is able to continue his profession without any difficulty.